Are there functional consequences of a reduction in selenium intake in UK subjects?

Dietary Se levels in the UK have fallen over the last 20 years and recent surveys indicate that average Se intakes are 30-40 microg/d, which is well below the current UK reference nutrient intake for adult men (75 microg/d) or women (60 microg/d). Functional consequences of this decline have not been recognised, although epidemiological data suggest it may contribute to increased risk of infections and incidence of some cancers. Previous data have indicated that biochemical changes in Se-dependent proteins occur in otherwise healthy UK subjects given small Se supplements. The current studies have focused on the effect of small Se supplements on the immune response since there is evidence of specific interactions between Se intake and viral replication, and since the potential anti-cancer effects of Se may be mediated by non-antioxidant effects of Se such as changes in immune function. Data indicate that subjects given small Se supplements (50 or 100 microg Se/d) have changes in the activity of Se-dependent enzymes and evidence of improved immune function and clearance of an administered live attenuated virus in the form of poliovirus vaccine. Responses of individual subjects to Se supplements are variable, and current work is evaluating potential explanations for this variability, including genetic variability and pre-existing Se status.     

Focus groups of Y-K Delta Alaska Natives: attitudes toward tobacco use and tobacco dependence interventions

BACKGROUND: Tobacco dependence interventions developed for Alaska Natives are virtually nonexistent. Alaska Natives residing on the Yukon-Kuskokwim (Y--K) Delta in southwestern Alaska use a unique form of smokeless tobacco (ST) known as Iqmik. This study employed focus group methodology to explore attitudes toward tobacco use and tobacco dependence interventions among Alaska Natives residing on the Y-K Delta. METHODS: Twelve focus groups of former and current tobacco users were conducted in four villages in the Y-K Delta. Participants were 35 adults (83% female) and 22 adolescents (27% female). Participants completed a brief demographic and tobacco use history form. Statements from the focus groups were transcribed for content coding and analysis of the major themes. RESULTS: Use of Iqmik in the villages is thought to be ubiquitous. Y-K Delta Alaska Natives are introduced to Iqmik at a very young age. Iqmik is mostly used and prepared by young Alaska Natives and adult women. There are few perceived adverse health effects of Iqmik or other tobacco use. Although there is interest in stopping, there is a perceived lack of availability of tobacco dependence interventions. The major barriers to preventing the initiation of and stopping tobacco use are the social acceptance and widespread use and availability of tobacco. CONCLUSION: The attitudes toward tobacco and identified barriers to stopping will be useful in developing tobacco dependence interventions for Alaska Natives.     

Prenatal protein restriction does not affect the proliferation and differentiation of rat preadipocytes

Poor development in utero may favor the development of obesity in adulthood. Animal studies showed that embryo manipulation in vitro or nutritional insults during the embryonic and fetal stages of development may lead to obesity in adult life. We studied the in vitro proliferation and differentiation of adipocytes to investigate whether early protein restriction may program cell growth and development. In a series of experiments, 2 different low-protein diet protocols were compared. In both cases, pregnant rats were fed a diet with a high (18-20%) or low (8-9%) protein content during gestation and/or lactation. Preadipocytes were isolated from the fetuses, neonates, and weanling offspring. Moderate protein restriction, imposed during either gestation and/or lactation, did not affect the capacity of preadipose cells to divide or store fat. Because previous studies showed that early protein restriction alters the metabolism of sulfur amino acids, we also investigated the effects of methionine, taurine, and homocysteine on proliferation and differentiation of preadipocytes. The supplementation of the diet with methionine or the addition of homocysteine and taurine to the culture media did not influence the development of preadipocytes. We obtained no evidence for the direct reprogramming of the precursor or stem cells and suggest that the subsequent alteration in fat accretion may therefore reflect a change in the neuroendocrine environment.     

A new instrument for pain assessment in vulvar vestibulitis syndrome

Vulvar vestibulitis syndrome (VVS) is a common form of dyspareunia in premenopausal women. The standard test for diagnosing VVS is the cotton-swab test, during which a cotton-swab is applied to various locations of the vulvar vestibule. However, there is much variation in the implementation of this test relating to the precise vestibular locations palpated, the order of palpation, and the force used during palpation. We introduce a new simple, mechanical device, a vulvalgesiometer, to standardize genital pain assessment and present promising preliminary data from women with VVS and nonaffected women. These data indicate that women with VVS have significantly lower vestibular pain thresholds compared with control women. During painful vulvar stimulation with the vulvalgesiometer, women with VVS described the pain with adjectives similar to those used to describe their intercourse pain (e.g., burning). This novel device has several important implications for genital pain measurement in women who suffer from urogenital pain.     

Static and dynamic analysis of the anterior segment with optical coherence tomography

PURPOSE: To study biometric modifications of the anterior segment with accommodation and age and determine possible applications in areas of anterior segment surgery, particularly implantation of refractive lenses. SETTING: Clinique Monticelli, Marseille, France. METHOD: The study comprised subjects between 7 years of age and 82 years of age in whom anterior chamber biometry was evaluated using 1,310 nm wavelength optical coherence tomography (OCT). The equipment has a fixation target that can be focused and defocused with negative lenses to stimulate natural accommodation. All measurements were performed by the same operator. The horizontal diameter of the AC, the anterior chamber depth (ACD), the horizontal pupil diameter, and the horizontal radius of curvature of the crystalline lens' anterior pole were measured in the unaccommodated state and after stimulating accommodation. RESULTS: Fifty-six subjects (104 eyes) were included; the refractions ranged from +5.0 diopters (D) to -5.0 D. The static and dynamic measurements were compared with ametropia, age, and accommodation. At rest, the mean AC diameter was 12.334 mm, the mean ACD was 3.106 mm, and the mean pupil diameter was 4.258 mm. With 1.0 D of accommodation, the anterior pole moved forward by a mean of 30 microm, the radius of curvature decreased 0.3 mm, and the pupil diameter decreased 0.15 mm. CONCLUSIONS: The AC OCT is a user-friendly instrument for evaluating the anterior segment and examining the AC (cornea, iris, crystalline lens, and iridocorneal angle). The 1,310 nm light wavelength is blocked by pigments, preventing examination behind the iris. However, the AC OCT is capable of good image quality and visualization of the anatomical relationships in the anterior segment, even behind an opaque cornea.     

Correction of presbyopia with refractive multifocal phakic intraocular lenses

PURPOSE: To evaluate the efficacy of and specify the conditions required for implantation of an anterior chamber multifocal phakic intraocular lens (IOL) to correct presbyopia. SETTING: Monticelli Clinic, Marseilles, France. METHOD: Fifty-five eyes of 33 patients (21 women, 12 men) had implantation of a foldable anterior chamber multifocal phakic IOL. The initial refraction was between -5.00 diopters (D) and +5.00 D. The IOL had an addition of +2.50 D. An uncorrected distance acuity of 0.6 or better (decimal scale) and an uncorrected near acuity (Parinaud scale) of 3 or better (Parinaud 2 approximately equal to Jaeger 1) was considered a successful postoperative result. RESULTS: The mean follow-up was 42.6 weeks +/- 18 (SD). Postoperatively, the mean refraction was -0.12 +/- 0.51 D, the mean decimal uncorrected distance acuity was 0.78 +/- 0.20, and the mean Parinaud uncorrected near acuity was 2.3 +/- 0.6. Eighty-four percent of eyes achieved an uncorrected distance acuity of 0.60 or better and an uncorrected near acuity of Parinaud 3 or better. The IOL was explanted in 4 eyes for different, but essentially optical, reasons. No significant anatomic complications were observed. CONCLUSIONS: Implantation of an anterior chamber multifocal phakic IOL to correct presbyopia was effective and gave good predictability. The procedure is reversible in cases of patient intolerance to the IOL, unwanted optical phenomena, or complications. Strict inclusion criteria should be used for patient selection.     

Phototoxic maculopathy after secondary intraocular lens implantation

We report phototoxic maculopathy in 2 aphakic patients after secondary, scleral-sutured intraocular lens implantation. This rare complication may have been triggered by drugs that increased the photosensitivity of the tissue. Careful preoperative assessment is necessary to question the receipts of photosensitizing drugs and identify diseases that predispose patients to phototoxic injuries.